Gelfand M C, Winchester J F, Knepshield J H, Cohan S L, Schreiner G E
Trans Am Soc Artif Intern Organs. 1978;24:239-42.
Ten patients in stage IV hepatic encephalopathy who had not responded to conventional therapy for at least 48 hrs were treated with one or more 4 hr periods of hemoperfusion. Nine (90%) awoke, and 4 (40%) are alive to date, the survivors having acutely toxic and infective hepatic lesions. Biochemical changes that occurred were a reduction in blood ammonia of 23%, a rise in the ratio of branched chain to aromatic amino acids in blood (1.08 +/- 0.3 to 1.3 +/- 0.4), and cerebrospinal fluid (0.26 +/- 0.02 to 0.32 to 0.03), and a rise in cerebrospinal fluid cAMP from 2.3 +/- 0.7 ng/ml to 3.4 +/- 1.29 ng/ml with hemoperfusion. Administration of platelets and fresh frozen plasma restored the reduction of platelet counts of 29% towards pretreatment values.
10例IV期肝性脑病患者，对常规治疗至少48小时无反应，接受了一个或多个4小时的血液灌流治疗。9例（90%）苏醒，4例（40%）至今存活，存活者有急性中毒性和感染性肝脏病变。发生的生化变化包括血氨降低23%，血液中支链氨基酸与芳香族氨基酸的比例升高（从1.08±0.3升至1.3±0.4），脑脊液中该比例升高（从0.26±0.02升至0.32±0.03），血液灌流时脑脊液环磷酸腺苷从2.3±0.7纳克/毫升升至3.4±1.29纳克/毫升。输注血小板和新鲜冰冻血浆使血小板计数降低的29%恢复至接近治疗前水平。
